Kysa C Radley Osborne, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6124439-3501 Issued in UT

Practice address

2500 S State St
South Salt Lake, UT 84115-3164

Phone

(385) 646-5000

NPI assigned

Jun 7, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1649909482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13737 S ANNIE LACE CIR",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207500",
            "telephone_number": "801-541-5943",
            "fax_number": "385-646-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S STATE ST",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841153164",
            "telephone_number": "385-646-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADLEY OSBORNE",
        "first_name": "KYSA",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "6124439-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pro DME LLC
• Marisa Christine Pugh, PTA
• Heidi Qin
• Caroline Chau Quach
• Melissa Radcliffe, APNP
• Janine Robyn Radley, SLP
• Cescilee Rene Rall, RN
• Veronica Ramirez
• Linsday Ramsey, RN
• Christopher Rasmussen

• Clinical Social Worker in South Salt Lake, UT
• Providers in South Salt Lake, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.